When Life Becomes Therapeutic

Sep 20, 2017

From a patient’s perspective of experiencing a “non – injurious” onset of pain, understanding why they hurt is among the most common questions or concerns we encounter as physical therapists.

Certainly if there was a fall, or a noticeable strain or worse yet a car accident, the reasoning and explanation for the pain is much more obvious. Further, if medical imaging (X-ray or MRI) offers an explanation, this can at least provide a contributing reason. Often enough, this understanding provides peace of mind.

However, for the pattern of pain, let’s call it chronic pain that seemed to all of a sudden “just be there,” to a point of it now being a part of one’s day to day existence, requires a deeper understanding of how such pain is generated. In support of explanation to sources of such pain as well as direction towards true healing we need to recognize two key influences: nature of survival and leverage.

As humans in the face of any threat, real or perceived we are both reflexively capable and instinctively inclined to survive. Generally a good thing, for example, a natural response to an environmental threat such as shivering to stay warm or sweating to cool off are both reflexive examples for involuntarily preserving our wellbeing. Yet with respect to contributions of a perpetuating pain, an example of a frequently witnessed yet often unrecognized source of pain provocations are our own physical reactions such as physically protecting or otherwise compensating for some underlying impedance to our wellbeing.

For example, limping out of bed with morning lower back stiffness, limping to work with lingering knee soreness, limping during walking exercise and yes limping without even knowing it, are all examples where we are living in survival mode. Not life threatening by any means, but none the less, life as we know it (our livelihood, our personal image or role to another person, our social calendar, our goals or athletic performance) is under threat.

Other examples you might recognize are slumping especially when tired, tensing to turn your neck, or shrugging your shoulder to reach that higher shelf. The underlying activation of such altered movements initially originates from either a pain avoidance (past or present) or making up for, or compensating for, an underlying physical deficit (joint mobility restriction, muscle weakness). This mechanism of physical adaptability is initially both meaningful and beneficial, yet when allowed to linger by failing to fully address the underlying limitations of healthy movements has its consequences for our choosing to exist long term in “survival mode.”

This brings me to our second defining word to provide explanation, that of leverage. If you have ever used a pair of pliers or appropriate sized scissors, a hammer or a pry bar, then you understand the meaning of using leverage to make a physical task easier. For the body, the urgency to either avoid pain or the necessity to make up for some underlying weakness or physical restraint to our mobility is no different.

For example, think of the times you were trying to open a tight jar and the resultant strategies and contortions you put your body into. Our physical makeup of a multitude of muscles, joints and the orchestrator of movement (our brains) provides an abundance of mechanical options to utilize. The choice of movement typically is either what doesn’t hurt or what can most readily get us through our day’s demands.

The down side of such alterations of movement becoming our new normal, different from that which we were designed to move, are twofold in terms of pain provocations:

Mechanical strain and ultimately tissue breakdown leading to pain signals “Houston, we have a problem.”

One compensation leads to another. As initial alterations of movement overload portions of us that are ill equipped to fulfill that functional movement pattern the consequence is that yet another adaptation is required and then another and another.

By design our daily movements through life are not intended to just accomplish tasks, but additionally to physically contribute to the health of our tissues and preservation of our own wellbeing. The resultant consequence however of surviving and leveraging through any portion of your life is ultimately your daily movement requirements are at a greater cost than replenishment. Repetitive leveraging ultimately “bundles” our joints into altered relations as our tissues adaptively shorten. These relational restraints lead to diminished dexterity, balance and otherwise movement fluidity. At Healing Motion Physical Therapy, it is not only our concern to resolve your sources of pain, rather to also insure that your own movements are no longer a contributing source. As Aristotle stated: “The whole is greater than the sum of its parts.” Restoring life’s movements to once again become therapeutic and ultimately healthy and enjoyable is one of the most life giving gifts you can provide for yourself.